Shopko Stores Operating Co. LLC
NPI #1174576854 in Sioux City, Iowa
Provider Information
- NPI Number
- 1174576854
- Entity Type
- Organization
- Organization Name
- Shopko Stores Operating Co. LLC
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- May 17, 2006
- Last Updated
- Feb 11, 2008
Practice Location
- Address
- 3025 HAMILTON BLVD
- City
- Sioux City
- State
- Iowa
- ZIP Code
- 51104-2407
- Phone
- (712) 255-5869
Authorized Official
- Name
- MICHAEL J BETTIGA, RPH
- Title
- SR. VICE PRESIDENT HEALTH SERVICES
- Phone
- (920) 429-4297
Specialties & Taxonomy Codes
| Specialty |
|---|
| Eyewear Supplier |
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